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[TKR] Good Strong Knee - No Bend<

Discussion in 'Knee Replacement Recovery Area' started by Gel-girl, Jan 27, 2018.

  1. Gel-girl

    Gel-girl member
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    D0FDEE9A-839C-421F-8B50-780DCF47CDCE.jpeg B6C96755-FE6D-4EFC-9803-78C20DD9A961.jpeg

    I received my x-rays through the post on a disc. I did not know how to copy and post so I took a photo of my laptop screen on my phone so I hope they are good enough.

    @Josephine can you see Arthrofibrosis from them or did OS diagnose from my symptoms? I have an appointment with a different OS at beginning of December and wondered how I should approach this. Any advice is appreciated.

    My knee is still very warm, moderately and permanently swollen, ROM is slowly getting worse on both extension and flexion and pain seems to be growing - if that makes sense.
     
  2. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Honey, those images are too small - only 320px × 240px. I need them to be at least 1,000px x 1,000px.
     
  3. Gel-girl

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    Ok will try but I keep getting ‘file too big’! Thanks for coming back to me I’ll have a go tomorrow
     
  4. Gel-girl

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  5. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    They're perfect! But I have resized the ones here as they are a better size for looking at.

    As for seeing arthrofibrosis, that's soft tissue and xrays don't generally 'see' soft tissue.
     
  6. Gel-girl

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    Thanks for that @Josephine so when the os said hard adhesions he must have felt them. Let’s hope the appointment in December sees a different outcome than ‘You’ll just have to live with them’!
    I don’t know if it’s psychological but the pain seems to be getting worse so I’ve taken your advice and I’m taking paracetamol 8 a day regularly throughout 24 hours. It’s extremely painful if I sit (with leg elevated) for any length of time so I’m trying to move regularly too.
    Thanks again Josephine very much appreciated.
     
  7. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Tell me, does this mean you are laying with your leg totally flat like this because that certainly will cause you a LOT of pain.

    elevating angles.jpg

    Have you been told to never bend your knee when you rest? Then ignore it! I know some doctors, nurses and PTs seem to have this idea (and preach it) that if you lie with your leg bent, it will set like that and you'll never get good flexion again. This is a real old wives' tale and has no truth in in it. If you were to lie like that most all day for a week or more, then it's most likely your knee would stiffen up but I doubt that's what you are doing. Sensible people will naturally get up and move around, whether it be to the bathroom or kitchen, it's movement and a modicum of that will ward off any stiffness in that situation.

    Anyway, it's quite unnatural for the knee to be completely straight all the time but you can bend it some, like these examples

    elevate 2-horz-horz.jpg
     
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  8. Gel-girl

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    I bend when elevating, always have, like middle and end picture. I was told early on by PT to put my heel on stool and leave for 20 mins could only manage 2 mins!! Tried putting half way up calf so only knee was off but that was too painful too so I don’t do any of those exercises at all. In fact I don’t do anything now but walking. This seems to help as pain goes away as I walk. It’s just the down hills and up and down steps that are painful and always have been before and after tkr. Thanks again for advice.
     
  9. Celle

    Celle FORUM ADVISOR Forum Advisor

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    That was bad advice from your PT. You should never do anything that goes beyond discomfort into pain. Even 2 minutes was too long at first. 20 minutes should have been the ultimate target, not the beginning instructions.

    The best way to improve extension is simply by walking, making your stride a little longer than usual. That will naturally stretch the tissues at the back of your leg.
    heel-toe-gait.jpg
     
  10. Celle

    Celle FORUM ADVISOR Forum Advisor

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    It's still very early days. These pains will decrease gradually, as your knee heals.
     
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  11. Gel-girl

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    A year is not that early @Celle. The Arthrofibrosis-hard adhesions are the big problems at the moment. I’ve generally followed BS advice so I reckon if I hadn’t got hard adhesions I’d have been fine by now. I’m the 5-30% that are unlucky according to stuff I’ve read so far about Arthrofibrosis. I just hope the next OS I see in December says he can do more than the last one. Thanks for the advice and support Celle is very much appreciated.
     
  12. Gel-girl

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    @Josephine sorry to be a nuisance but something the original OS said was ‘if you went to another OS they may put a looser knee in to give you more flex’. Would this work and do my xrays show my joint has tightened (which doesn’t make sense to me but it may to others)!
     
  13. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    What ever makes you think that? The likelihood is that you have chronic inflammation in your soft tissues.
    I can't say if it would work or not but I do know that such things do not show up on xrays.
     
  14. Gel-girl

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    Interesting information @Josephine thanks again much appreciated. Hope I get an OS that knows his stuff and asks for different scans to show how good or bad I am.
     
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  15. Gel-girl

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    Saw the NHS surgeon today.

    He’s not ruling out infection because of the heat and swelling of the knee. He also thought my leg was slightly turning out.

    So I was sent off for bloods to be taken and then he’ll see me when they come back. I’m a little confused how they will let me know so I’ll ring tomorrow to find out the system. I should have asked but I get caught up in the whole efficiency of it all.

    One thing surprised me he said “and most of your pain comes from here” resting his hand on the inside front of my knee. Yes it does and also the back of my knee but mainly where he said. How did he know this. Is this where Arthrofibrosis shows pain. Should have asked why!
     
  16. sistersinhim

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    I bet that's where he had to do most of the work on your knee.
     
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  17. Gel-girl

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    Saw the NHS surgeon again beginning of January. The bloods are fine - showing no infection. He explained that did not rule out infection. He told me he would be inclined to do a biopsy and while there to take away some of the scar tissue but he strongly felt that I needed a revision. As an independent surgeon he did not believe he would give me a full service. He thought I should be looked at by a surgeon with a team who can work with my knee. So I have my next appointment in mid March with another surgeon.
     
  18. Gel-girl

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    Saw the surgeon himself last Friday. I’ve now seen all outcomes. The first surgeon (the original) sent me packing saying nothing can be done and to get on with life! The second was really quite positive saying to come back and show him how well I have got on! The third (last Friday) really sat on the fence and talked about every outcome and where did I want to be! I told him months after I had had my tkr I was in so much pain I didn’t want anyone to touch my knee ever again but as time has gone on and my abilities have not been gained I will try anything to be able to walk as I did, cycle as I did and be able to sit on the toilet again - as I did! I’m still in quite a bit of pain especially at night and would love a good nights sleep without being waken with pain (I am still taking paracetamol regularly over 24 hours plus codeine if the pain is extremely bad). I am too young to feel this old.

    He has organised more bloods to be taken and a CAT scan to be carried out. He did quite a thorough examination of my knee and was surprised how I couldn’t straighten it even with him pushing quite strongly down. He thinks the knee is quite strong. He mentioned maybe performing a knee arthroscopy and shaving some of the adhesions away - a little worrying as, I believe, this technique can cause bleeding which can cause more adhesions. I worry that my arthrofibrosis will not be taken away correctly and that surgeons will think I’m a bit of a know-all if I say anything about cutting and cauterise rather than shaving is perhaps a better way to do it - please, anyone, let me know if I’m wrong in thinking this.

    Oh well it’s just a waiting game now.
     
  19. Jockette

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    Very frustrating for sure! I’ve had 2 second opinions and they don’t see anything wrong.
     
  20. Gel-girl

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    Oh dear @Jockette at least they see something is wrong in me! Don’t give up
     

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